20th February 2025

A 61-year-old woman presents to hospital with subacute rhinosinusitis which has failed to respond to antibiotic therapy in primary care.

A 61-year-old woman presents to hospital with subacute rhinosinusitis which has failed to respond to antibiotic therapy in primary care. She also reports nasal crusting, cough, intermittent fevers and general malaise, and has noted her urine output has been decreasing. Her past medical history is significant for osteoarthritis and hypertension.

Her chest radiograph shows multiple bilateral upper nodules. Her bloods show a raised WCC and CRP. Her creatinine is 423 micromol/L (normal: 55-120 micromol/L) and her GP records show a historic creatinine of 110 micromol/L two years ago. A renal screen is sent.

Which of the following is most likely to come back positive from her renal screen?

Select the SINGLE most appropriate option from the list below. Select ONE option only.